Outcome analysis of chance fractures of the skeletally immature spine.

Study Design: Observational.

Objective: The authors present a detailed description of 25 skeletally immature patients with Chance fractures with a mean follow-up of 6.4 years.

The efficacy of video-assisted thoracoscopic surgery for anterior release and fusion in the management of pediatric spinal deformities.

Purpose: This study examined clinical and radiological outcomes following video-assisted thoracoscopic surgery (VATS) for anterior release and fusion in the correction of pediatric scoliotic deformities.

Methods: We undertook a detailed chart and radiographic review to determine the degree of correction and perioperative morbidity and complications, if any, of a sequential group of patients who underwent VATS between 2000 and 2004 at British Columbia's Children's Hospital. We used patients who underwent open thoracotomy immediately before the adoption of the VATS technique at the same hospital to evaluate the relative efficacy of VATS.

Transarticular screws in the management of C1-C2 instability in children.

C1-C2 instability is a challenging problem in the pediatric population. Small patient size and poor healing potential in the at-risk groups, such as patients with Down syndrome and os odontoideum, make fixation difficult. Instability in patients with Down syndrome is a common problem, and traditional methods of fixation have a high complication rate and are a challenge given the frequent anatomic abnormalities such as an incomplete or hypoplastic arch, os odontoideum, and incomplete passive reduction.

Abdominal aortic injuries associated with chance fractures in pediatric patients.

Injury to the abdominal aortic artery from blunt trauma is an infrequent event with few cases reported in either the adult or the pediatric literature. Injury to the thoracic aorta after blunt abdominal trauma is more common. It has been estimated that 95% to 99% of all aortic disruptions are in the thoracic region.

Sternal split approach to the cervicothoracic junction in children.

Study Design: We present a descriptive case series outlining the surgical technique and outcome in six patients managed with a combined anterior neck and sternal splitting approach.

Objectives: To describe a surgical approach used in the management of severe cervicothoracic kyphosis and/or scoliosis in pediatric patients.

Summary Of Background Data: There are few reports in the literature that address the problem of accessing multileveled spinal deformities around the cervicothoracic junction requiring stabilization in the pediatric population.

Os odontoideum: a significant radiographic finding.

Os odontoideum can lead to instability of the atlantoaxial joint and places the spinal cord at significant risk for acute catastrophic events after minor trauma or chronic neurological change. We present two cases of os odontoideum in pediatric patients that were not appreciated at earlier remote imaging but were, in retrospect, detectable. One patient presented with an acute spinal cord injury.

Treatment of idiopathic clubfoot utilizing botulinum A toxin: a new method and its short-term outcomes.

A pivotal point in most clubfoot management protocols is Achilles tendon lengthening or tenotomy to address hindfoot deformity. The effectiveness of botulinum A toxin (BTX-A) in attenuating the function of the triceps surae muscle complex as an alternative to tenotomy was investigated. Fifty-one patients with 73 idiopathic clubfeet were recruited.